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慢性风湿性疾病患儿的血脂谱——一项回顾性分析

Lipid profile of pediatric patients with chronic rheumatic diseases - a retrospective analysis.

作者信息

Rodrigues Wellington Douglas Rocha, Sarni Roseli Oselka Saccardo, Abad Thais Tobaruela Ortiz, Silva Simone Guerra Lopes da, Souza Fabiola Isabel Suano de, Len Claudio Arnaldo, Terreri Maria Teresa

机构信息

. Nutricionista, Doutor, Departamento de Pediatria, Universidade Federal de São Paulo, São Paulo, SP, Brasil.

. Médica assistente e pesquisadora associada, Universidade Federal de São Paulo, São Paulo, SP, Brasil.

出版信息

Rev Assoc Med Bras (1992). 2020 Aug;66(8):1093-1099. doi: 10.1590/1806-9282.66.8.1093.

Abstract

AIM

To describe the prevalence of dyslipidemia in children and adolescents with autoimmune rheumatic diseases (ARDs), particularly juvenile idiopathic arthritis (JIA), juvenile systemic lupus erythematosus (jSLE), and juvenile dermatomyositis (JDM).

METHODS

Retrospective cross-sectional study conducted in the pediatric rheumatology outpatient clinic. We evaluated 186 children and adolescents between the ages of 5 and 19 years. The medical records were reviewed for the following data: demographic and clinical features, disease activity, and lipid profile (triglycerides (TG), total cholesterol (TC), low density lipoprotein (LDL-C), high density lipoprotein (HDL-C) and very low density lipoprotein (VLDL-C)). In addition, non-HDL cholesterol was calculated as TC minus HDL-C. The cut-off points proposed by the American Academy of Pediatrics were used to classify the lipid profile.

RESULTS

Dyslipidemia was observed in 128 patients (68.8%), the most common being decreased HDL-C (74 patients, 39.8%). In the JIA group there was an association between the systemic subtype and altered LDL-C and NHDL-C, which demonstrated a more atherogenic profile in this subtype (p=0.027 and p=0.017, respectively). Among patients with jSLE, the cumulative corticosteroid dose was associated with an increase in LDL-C (p=0.013) and with a decrease in HDL-C (p=0.022).

CONCLUSION

Dyslipidemia is common in children and adolescents with ARDs, especially JIA, jSLE, and JDM, and the main alteration in the lipid profile of these patients was decreased HDL-C.

摘要

目的

描述自身免疫性风湿性疾病(ARDs)患儿及青少年,尤其是幼年特发性关节炎(JIA)、青少年系统性红斑狼疮(jSLE)和幼年皮肌炎(JDM)患者血脂异常的患病率。

方法

在儿科风湿病门诊进行回顾性横断面研究。我们评估了186名年龄在5至19岁之间的儿童和青少年。查阅病历以获取以下数据:人口统计学和临床特征、疾病活动度以及血脂谱(甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)、高密度脂蛋白(HDL-C)和极低密度脂蛋白(VLDL-C))。此外,非高密度脂蛋白胆固醇计算为TC减去HDL-C。采用美国儿科学会提出的切点对血脂谱进行分类。

结果

128例患者(68.8%)存在血脂异常,最常见的是HDL-C降低(74例,39.8%)。在JIA组中,全身型亚型与LDL-C和非HDL-C改变之间存在关联,这表明该亚型的动脉粥样硬化风险更高(分别为p = 0.

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